Montgomery Street, San Francisco, CA94105(555) 432-1000, resumesample@example.com
Executive Profile
Over 23 years experience working in the healthcare industry; building and supporting both operational and analytical systems Strong oral and written communication skills; significant experience working with business and IT senior leadership in developing and implementing strategic solutions Over 19 years experience building and overseeing large application development teams Over 12 years experience developing and managing SG&A and capital project budgets Significant experience in working with vendors on tool selection, contract and procurement processing Significant experience in working with external software consulting vendors (on and off shore) in both a fixed rate and hourly rate structure.
Skill Highlights
VAX and ALPHA (VMS operating system), NT, IBM/AIX
Software: MS Office, MS Project, Business Objects, COBOL, Visual Basic, JAVA, HTML, ASP, Pillar budgeting software
Databases: RDB (relational database system for VMS), Oracle
Core Accomplishments
Oxford Health Plans 2003 - 2005, UnitedHealth Group 2005- Present Trumbull, CT Senior Director (2003 -2011) - Information Technology (Dual role - Program/Portfolio Management and Application Development Staff Management) In Program and Portfolio Manager functions, work with Senior Business and IT Management to develop strategic and technical roadmaps for programs to enhance Oxford Health Plans in the areas of data management, member and group growth/retention, affordability and system stability.
Responsibilities include: Participate in the annual business planning activities including solution approach and business case development Facilitate development of program level technical and business strategy roadmaps Oversight of program/project plans and deliverables, including mentoring program/project managers Facilitate business core team and steering committee meetings Develop and provide oversight of capital budget requirements (staff, hardware, software, consultants) Facilitate vendor selection (tools & software consulting), contracting and procurement process Provide oversight of external vendor relationships Create and present status reporting to business and IT management Project team management direct and matrix (including managers, program/project managers, systems analysts and programmers) ranging in sizes up to 100 employees.
Ensured adherence to standard SDLC processes.
2007 - 2011) Oxford Health Plan platform enhancements (4+ year, cost - 35M) - Series of programs to enhance Oxford Health Plan system capabilities in support of annual business goals.
Provided direct management oversight of the following programs: Member Growth / Retention - Redesign of Oxford member portal to function / "look and feel" similar to myUHC.com, Enhancements to broker quoting and enrollment portal to meet new product requirements, implementation of large group and ASO web based reporting on Oxford portal, Health Net migration initiative, etc Affordability - Accumulation upgrades to support enhanced EOB format, Implementation of MNRP pricing utilizing PPOne pricing engine integration with Oxford platform, migration of PBM for Medicare membership from MEDCO to Rx Solutions System Stability - Migration from obsolete FORTE technology to JAVA for critical applications, Oracle Financials system upgrade to supportable version, PULSE database upgrade from 9i to 10G, critical data archival process development and execution 2003-2006) Oxford Health Plan Data Management Initiative (3+ year, cost - 10M) - Series of programs to enhance Oxford Health Plan capabilities in the areas of data warehousing, data access, self-service reporting, standardized data extracts, stewardship and metadata management.
Accomplishments included the following components: Reporting and ETL tool, hardware - vendor selection, contracting and procurement.
Successful implementation into production.
Operational data store and analytical data warehouse implementation including foundational components - membership and claims.
Self-service reporting applications implemented servicing over 700 internal users.
Standard data extracts servicing over 40 external clients.
Implementation of data stewardship program to manage access level to self-service and standardized extracts In Application Development Management function (2003 - 2009), oversaw 60+ employees (Directors, Managers, Program / Project Managers, Systems Analysts, Technical Architect/Lead, Programmers)in providing production support and enhancing operational and analytical systems.
Responsibilities included: Business relationship management (prioritization, annual business planning, etc), across a number of departments including Medical Management, Pharmacy, Claims, Capitation, Finance, Actuarial and Underwriting.
Responsible for all HR functions including recruiting, performance reviews, career development, mentoring and counseling Responsible for all budget functions including SG&A and capital management, as well as consultant contracts and oversight.
Led effort to integrate ETS process and tools into application development workflow.
Provided support in moving from Oxford specific SDLC processes to UDP/ADR and UHG IT SARS procurement process HEALTH NET Woodland Hills, CA 1992 - 2003 Manager (1992-1997) / Director (1997-2003) - Information Services (Dual role - Program Management and Application Development Staff Management) In Program Manager function, worked with Senior Business and IT Management to develop strategic and technical roadmaps for multi-year programs in the areas of capitation processing, data management and acquisition data integration.
Responsibilities included: Facilitated development of technical and business strategy roadmaps Development and oversight of plans and deliverables Facilitation of business core team and steering committee meetings Development and oversight of capital budget requirements (staff, hardware, software, consultants) Facilitation of vendor selection, contracting and procurement process Creation and presentation of status reporting to business and IT management Staff management of project team (including managers, program/project managers, systems analysts and programmers) ranging in sizes up to 50 employees, including HR responsibilities Enterprise Capitation Processing (2 year, cost - 7M) - Consolidation of six Capitation systems supporting commercial and medicare business lines to one enterprise capitation processing system.
Oversaw development of overall strategy and program plan, as well as successful implementation of enterprise capitation processing engine.
Data Management (3+ year, cost - 7M) - Enhancements to Health Net's capabilities in the areas of data warehousing, access, self-service reporting, stewardship and metadata management.
Historical Data Integration (1.5 year, cost - 2M) - Migration of acquired company (Foundational Health Systems) historical data into the corporate data warehouse.
In Application Development Management function (1992 - 2003), oversaw teams up to 70+ employees in providing production support and enhancing operational and analytical systems.
Responsibilities included: Business relationship management (prioritization, annual business planning, etc), across a number of departments including Medical Management, Pharmacy, Claims, Capitation, Finance, Actuarial and Underwriting.
Responsible for all HR functions including recruiting, performance reviews, career development, mentoring and counseling Responsible for all budget functions including SG&A and capital management, as well as consultant contracts and oversight.
Professional Experience
01/1991 to 01/1992Manager, Production Control DepartmentCalifornia Bank & Trust | Houston, TX,
Managed and supported a 24/7 systems operation department responsible for executing business applications.
Worked with production support analysts that evaluated all production job streams and automated job submissions.
Built and executed a strategic plan to consolidate to a single job scheduler system, standardize job stream programming (including error handling), automate file transmission, disk space monitoring, system file purging, etc.
Managed personnel functions including performance reviews, counseling and career development.
01/1988 to 01/1991Business Systems Analyst | , ,
Acted as liaison between software development group and internal/external clients.
Responsible for project management tasks that included: project planning, resource management, status reporting and issue resolution.
01/1987 to 01/1988Implementation ConsultantHarris Computer Systems | City, STATE,
Responsible for installing PC based funds transfer and cash management systems and training staff.
Demonstrated product capabilities, while answering application and technical questions.
Education
Expected in 1987B.S | Mathematics and Computer ScienceHofstra University, Hempstead, NYGPA: Mathematics and Computer Science
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